BREAST FEEDING

Ns. Nur Falah Setyawati, S.Kep.,

MPH
 Principles involved in Breast
Feeding
 Anatomy & Physiology
involves the anatomy of the breast feeding the baby. 
 Body Mechanics
involves proper positioning in feeding the baby. 
 Microbiology
involves the cleaning of the breast before you let the baby
suck the breast of the mother to avoid infections. 
 Physics
involves friction due to the sucking of the baby of the
breast 
 Time and Energy
it saves time and conserves energy rather than bottle feeding.
Indications and Contraindications of
Breast Feeding

Indications :
 Newly born babies
 Need for nutrition
 When mother is lactating
 Contraindications :
 A mother w/ a diagnosis of breast cancer
 Women w/ HIV/AIDS
 Maternal medications
 Heavy sedations of the mother
 Physical compromise of either mother or
baby
 Hepatitis B virus
 Herpes lesions on the mother’s nipples
 Advantages and Disadvantages of
Breastfeeding
Advantages for Infants :
 Provides a favorable balance of nutrients with high bioavailability
 Provides hormones that promote physiological development
 Improves cognitive development
 May protect against some chronic disease such as diabetes and
hypertension later in life
 Protects against food allergies
 Decreased incidences of ear infections, diarrhea, and some
respiratory problems in breastfed babies.
 Breast-fed infants gain less weight and tend to be leaner at 1 year
of age than formula-fed infants. This early indicator may influence
later growth patterns, resulting in fewer overweight and obese
children.
 Advantages for Mothers:
 Breast-feeding releases a hormone in a woman's body that causes her
uterus to return to its normal size and shape more quickly and
reduces blood loss after delivery.
 Delays the return of the regular ovulation thus lengthening birth
intervals
 Conserves iron stores by prolonging amenorrhea
 Breast-feeding for longer periods of time (up to 2 years) and among
younger mothers may reduce the risk of premenopausal and possibly
postmenopausal breast cancer.
 Most women who persevere with breast-feeding have a great sense
of accomplishment and recognize the importance of providing their
child with the best possible nutrition.
 Mothers who breastfeed their babies have fewer episodes of post-
delivery depression.
 Disadvantages of Breast Feeding :
 Breast discomfort
 Sore or leaking nipples
 Increased incidents of mastitis
 Engorgement
 Less personal time than in bottle-feeding
 Vaginal dryness *medications such as
metronidazole use to treat trichomoniasis pass into
the breast milk and maybe harmful to the breast-
feeding infant
 Exclusion of father from the nurturing involved in
feeding the infant.
 Mechanisms:
 Sucking- stimulates the release of oxytocin
 Oxytocin - is a hormone produced by the posterior
pituitary that stimulates uterine contractions and
release of milk from the mammary glands. It
increases the contractility of the myoepithelial cells
that lines the wall of the mammary ducts resulting
in the let-down reflex. 
 Let-Down Reflex- is the ejection of milk from the
breast and milk flow toward the nipple triggered by
nipple stimulation or emotional response for the
infant
 Acronym of Breast Feeding
 B- Best for baby
 R- Reduces incidence of allergies
 E- Economical
 A- Antibodies-provides immunity to some disease
 S- Stool is inoffensive and hardly constipated
 T- Temperature is always ideal
 F- Fresh- never goes sour
 E- Emotionally bonding
 E- Easy once established
 D- Digested easily
 I- Immediately available
 N- Nutritionally optimal (best)
 G- Gastroenteritis greatly reduce
Types of Nipples
 Is Baby Hungry?
Infant Feeding Clues
 Bringing hands to mouth or cheek and trying to
suck on them
 Rooting

 Lip smacking, mouthing, tongue protrusion

 Crying is a late feeding clue

 Menyusui Bayi

 Cuci tangan

 Posisi tubuh harus nyaman & benar

 Gunakan bantal atau handuk untuk menopang

 Buka payudara yang akan disusukan terlebih

dahulu
Breast Feeding Position
A. Football Hold
 Hold the baby’s back and
shoulders in the palm of
your hand
 Tuck the baby up under your
arm, lining up the baby’s lips
with your nipple
 Support the breast to guide it
into the baby’s mouth
 Hold your breast until the
baby’s nurses easily
B. Side Lying Position
 Lie on your side with a
pillow at your back and
lay the baby under the
breast facing each other.
 To start, prop yourself up
on your elbow and support
your breast with the
opposite hand
 Pull the baby close to you
turning up the baby’s
mouth with your nipples
C. Cradling Position
 Cradle the baby in the
arms closest to the
breast, with the baby’s
head in the crook of the
arm.
 Have the baby’s body
facing you, tummy to
tummy
 Use your opposite arm
to support the breast.
D. Across the Lap
Position
 Lay your baby on pillows
across the lap.
 Turn the baby facing you
 Reach across your lap to
support the baby’s back
and shoulders with the
palm of your hand.
 Support your breast from
underneath to guide it into
the baby’s mouth.
Offering Breast to Baby

 Fingers underneath,
thumb on top of breast
 Fingers well behind
areola
 Rooting Reflex and Latch-On

 Position baby correctly at breast with mouth

directly in front of nipple
 Use nipple to tickle baby’s lips until mouth
opens wide
 Support baby’s head

 Baby’s mouth is open wide enough to take in

nipple and most of areola
 Open wide…
 Quickly center the nipple
in baby’s mouth and pull
him toward a mother
 Baby’s lower jaw far back
from the nipple
 Baby’s chin on breast

 Nose may be on breast

PROBLEM IN BREASTFEEDING

 Sore or cracked nipples

 Engorgement

 Plugged Ducts

 Mastitis
 Sore or cracked nipples
 Can occur with improper positioning or latch.
 Preventing Sore or Cracked Nipples :
– Properly position infant
• Use pillows
• Check for good latch on
– Do not use ointments or creams
– Express a few drops of milk onto nipple after
feeding (antibacterial properties)
– Allow nipples to air dry
 Engorgement
 This is caused by additional blood that has rushed to the
breasts in order to assure adequate nourishment for the new
baby, and some swelling of tissues. Breasts may feel like
they will burst.
 Treatment:
– Nurse baby frequently -- emptying the breasts will relieve the congestion
– Use warm showers. May alternate between heat packs and ice packs
– Gentle breast massage -- with the palm of your hand, gently stroke the breast
downward toward the nipple. This is most effective when done under a
shower or while leaning over a bowl of warm water
– If engorgement causes the nipples to flatten and you are having difficulty
latching your baby on, you may try pumping or hand expressing some milk
first to relieve the fullness
– Breast shells can also be used between feedings to draw out flat nipples
– Sometimes placing a cold washcloth or ice pack on your nipple will help
bring it out
 Plugged Ducts
 May be caused by improper positioning, infrequent
nursings, supplementary bottles, overuse of pacifier,
bras that are too tight or other restrictive clothing.
 Tender spot, redness, or sore lump in breast

 Milk is unable to flow through duct leads to

inflammation
 Treatment:
– Change positions at each nursing: Lie down, sit up, switch
from rocking chair to the sofa to a lounge chair. A variety of
positions will give your baby a better chance to reach all of
the milk ducts and keep them emptied
 Mastitis

 Occurs when plugged duct is not treated

 Flu-like symptoms (tired, aches, fever)
 Nurse frequently- Mastitis will not harm baby
and the infection will clear up more quickly
when the breast is kept empty. Also,
antibiotics in your milk will protect your baby
from the bacteria that may be causing the
infection.
 Continued….
 Start treatment immediately
– Antibiotic Therapy
• Take all medication as prescribed
• Be sure your physician prescribes an antibiotic that is safe
for nursing mothers
– Other treatment strategies:
• Rest!
• Apply wet or dry heat to area
• Remove any dried milk secretions on nipple by soaking with
plain warm water
• Take warm showers
• Nurse on affected side frequently
• Loosen constrictive clothing, especially your bra
• After using warm packs or massage, nurse the baby or hand
express some milk immediately.
 Nursing Diagnosis Related to
Breasts and Breastfeeding
 Pain r/t improper positioning, engorged breasts
 Ineffective breastfeeding r/t maternal
discomfort, improper infant positioning
 Knowledge deficit r/t normal physiologic
changes, breastfeeding
 Infection r/t improper breastfeeding
techniques, improper breast care
 ?
Question
THANK YOU